HomeMy WebLinkAboutHYLEN CREST #3 BLK 6 LT 6Hylen Cees
lock 6
Lot 6
- 050-474
-3Z
Municipality of Anchorage
On-Site Water and Wastewater Section - (907) 343-7904 Page 1 of 3
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP211014 PID Number: 050-474-32
Dwelling: FE-111 Single Family (SF) El with ADU El Duplex (D) El Two Single Family Project: El New X Upgrade
Name
DAVID AND EMILY STREETS
ABSORPTION FIELD
F-1 Deep Trench M Wide Trench El Bed F-1 and
El Other
Site Address
10323 STEWART DR EAGLE RIVER
Phone
Number of Bedrooms
Soil Rating
depth fro riginal grade
1 4
GPD/SF
ITotal
Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
Ft.
Gravel depth beneath pipe
Ft.
Subdivision Block Lot
HYLEN CREST #3 6 6
Fill added above originalGravel
7�� Ft.
length
Ft.
Township Range Section
Gravel width
Ft.
Beds: Number of Lines
Distance between lines
Ft.
SEPARATION DISTANCES
TO
Septic
Absorption
Lift Station
Holding
Sewer
Total ab tron area
7
Number of trenches
Dist. between trenches
From
Tank
Field
Tank
Line
Ft'
Ft.
Well
>100'
na
nana
I
na
TANK N Septic S.T.E.P. [:]Holding E] Other
El
Manufacturer
INFILTRATOR
Capacity
1530 Gal.
Surface Water
>100
na
na
na
—
Material
Number of compartments
Lot Line
>5'
na
na
na
NA
PLASTIC
2
Foundation
7.4'
na
na
na
LST IZ-TATION
Manufacturer—
Capacity
Remarks tank has 2' insulation overtop
�
Gal.
includes Retrofast 0.375 treatment system
Alarm location
Zlecrrical stalled by
PIPE MATERIAL House totank 3034Tank to
drainfield 3034 s
Installer
ARM Septic Services
—
Drainfield CO/MT3034
Inspector Curtis Townsend
BENCH MARK (Assumed elevation) 100 ft
1st 2/9/2021 2/11/2021
Inspdates:
Location and description
2ection
3" 2/25/206 4111
bottom of siding point B
ON-SITE WATER AND WASTEWATER SECTION APPROVAL
Engineer's Stamp
ge,gv�_1�14
Conditional Approval: Date
............
4
®....
r . .
Iwnse
L f/.
DeL
119 ,.
.V-.,
Septic System
�151N
Approved \ mkDate 2,
Note: this approval does not include well permit requirements.
tmev uwuz/ i8)
I
THIS PROPERTY IS SERVED BY A PUBLIC WATER SYSTEM AND
THERE ARE NO WELLS WITHIN 200' LOCATION OF KEY BOX IS 4'
FROM WEST PROPERTY LINE. WATER LINE ENTERS HOUSE AS
SHO WN.
THIS PROPERTY DRAINED BY AN EXISTING 81' x 5' x 3.5'
EFFEC TI VE DEPTH TRENCH.
WR910021 ALLOWS FOR FIELD TO BE 5' FROM PROPERTY LINE.
UPPER TRENCH IS FULL OF WATER, LOWER TRENCH HAS 16" OF
WATER MEASURED JANUARY 2021.
NEIGHBORING SEPTIC IS > 10'
FROM PROPERTY LIN
LOT 7
4 BEDROOM
HOUSE 7.4
FICO
Imo' t1
/DRl VE WA
OPEI30q t
�s
7 i U.U[-
15' EASEMENT
S
STEWART DRIVE
NEW 1530 GALLON
TANK LOCATED > 5'
AWAY FROM FIELD
NEIGHBORING SEPTIC IS >
10' FROM PROPERTY LINE
LOT 5
SCOPE OF WORK
1. REMOVED EXISTING SEPTIC TANK.
_ 2. PLACED NEW 1,530 GALLON INFILTRATOR SEPTIC TANK AND TIE INTO EXISTING ABSORPTION
SYSTEM. THE TANK WAS PROVIDED WITH MINIMUM 20" 0 MANWAY RISER SERVING THE
FIRST AND SECOND COMPARTMENTS. TANK INCLUDES RETROFAST 0.375 TREATMENT
SYSTEM BY BIOMICROBICS. PUMPING ACCESS WAS PROVIDED TO SECOND COMPARTMENT. 2'
OF INSULATION WAS PROVIDED TO REDUCE BURIAL DEPTH TO LESS THAN 4'.
3. ALL CONSTRUCTION WAS IN ACCORDANCE WITH ALL REQUIREMENTS SPECIFIED IN
ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65.
Tank Replacement Record Drawings Prepared for
David and Emily Streets
10323 Stewart Dr, Eagle River Alaska 99577
HYLEN CREST #3 BLOCK 6 LOT 6
EKLUTNA ENGINEERING, LLC
19162 MOUNTAIN ROAD
CHUGIAK, ALASKA 99567
(907) 406-1058
OSP211014
DATE: 3/5/2021
DRAWN: CLT
SCALE: 1" = 30'
PID: 050-474-32 SHEET 2 OF 3
THE TANK IS 7.4' A WAY FROM THE HOUSE
FOUNDATION. THE TANK IS BURIED MAX 6'
BELOW GRADE. THERE IS 2' OF FOAM
INSULATION ABOVE THE INFIL TRA TOR TANK TO
ALLOW FOR A MAXIMUM SOIL DEPTH OF 4'
ABOVE THE TANK. THE FOUNDATION SOIL
PRISM IS SHOWN TO EXTEND BELOW THE
BOTTOM OF THE PROPOSED TANK.
MARK
A
B
SVi
31'-10"
10'-0"
SV2
29'—l"
1J'-11"
DCO
30'-4"
I 19'-0"
4.5
1:1 FOUNDATION PRISM
1, 530 G
PLASTIC TANK
2' INSULATION ON TOP
M
2
Tank Replacement Record Drawings Prepared for
David and Emily Streets .•�P�E OF .
10323 Stewart Dr, Eagle River Alaska 99577
HYLEN CREST #3 BLOCK 6 LOT 6 A :° , 49TH— •
/.................................... %
OSP211014
EKLUTNA ENGINEERING, LLCAr
DATE: 2/26/2021 :CURTIS TOWNSEND .
�No. CE 11904 ��
19162 MOUNTAIN ROAD DRAWN: CLT �i
�•.•z�f2� �2
CHUGIAK, ALASKA 99567SCALE: 1 1/2" = 1' ��Y'co••''••..1.....�'�i
(907) 406-1058
PID: 050-474-32 SHEET 3 OF 3
O
OLIJ
OO
mZ
Q
ZW
ZW
O�
�W
�v
�v-QQ.O
DU
9.-7
1, 530 G
PLASTIC TANK
2' INSULATION ON TOP
M
2
Tank Replacement Record Drawings Prepared for
David and Emily Streets .•�P�E OF .
10323 Stewart Dr, Eagle River Alaska 99577
HYLEN CREST #3 BLOCK 6 LOT 6 A :° , 49TH— •
/.................................... %
OSP211014
EKLUTNA ENGINEERING, LLCAr
DATE: 2/26/2021 :CURTIS TOWNSEND .
�No. CE 11904 ��
19162 MOUNTAIN ROAD DRAWN: CLT �i
�•.•z�f2� �2
CHUGIAK, ALASKA 99567SCALE: 1 1/2" = 1' ��Y'co••''••..1.....�'�i
(907) 406-1058
PID: 050-474-32 SHEET 3 OF 3
1113-6 f%S'''/irf 1910 .S"CJ
AQD1111 T_►In
-- ••• n1� vr+1 c. SEWARD & ASSOCIATES LAND -SURVEYING 66
I HEREBY CERTIFY THAT I HAVE SURVEYED THE SCALE:
FOLLOWING DESCRIBED PROPERTY: Lot 6, 1" = 30' „® bF A40%ft
Block 6, Hylen Crest Subd., Unit No. 3 DATE °� •• '9
AND THAT NO ENCROACHMENTS EXIST EXCEPT AS 12126191 ''` '•. r � '�` 4
INDICATED. IT IS THE RESPONSIBILITY OF THE ,; * T
OWNER TO DETERMINE'THE EXISTENCE OF ANY GRID: •- -- • ••= �= 8
EASEMENTS, COVENANTS, OR RESTRICTIONS • �< _.�
WHICH DO NOT APPEAR ON THE RECORDED SUBDI- NW57`"
FBS Duane Mark Seward
VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD �:'•, iS _ e ,�r
ANY DATA HEREON BE USED FOR CONSTRUCTION 25-71 � f�� `�• % �,� �
OF FENCE LINES, OR FOR ESTABLISHING BOUND- DRAWN``
ARY LINES. DMS
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�SM.i'
AQD1111 T_►In
-- ••• n1� vr+1 c. SEWARD & ASSOCIATES LAND -SURVEYING 66
I HEREBY CERTIFY THAT I HAVE SURVEYED THE SCALE:
FOLLOWING DESCRIBED PROPERTY: Lot 6, 1" = 30' „® bF A40%ft
Block 6, Hylen Crest Subd., Unit No. 3 DATE °� •• '9
AND THAT NO ENCROACHMENTS EXIST EXCEPT AS 12126191 ''` '•. r � '�` 4
INDICATED. IT IS THE RESPONSIBILITY OF THE ,; * T
OWNER TO DETERMINE'THE EXISTENCE OF ANY GRID: •- -- • ••= �= 8
EASEMENTS, COVENANTS, OR RESTRICTIONS • �< _.�
WHICH DO NOT APPEAR ON THE RECORDED SUBDI- NW57`"
FBS Duane Mark Seward
VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD �:'•, iS _ e ,�r
ANY DATA HEREON BE USED FOR CONSTRUCTION 25-71 � f�� `�• % �,� �
OF FENCE LINES, OR FOR ESTABLISHING BOUND- DRAWN``
ARY LINES. DMS
MUNICIPALITY OF ANCHORAGE
On -Site Water & Wastewater Program
PO Box 196650 4700 Elmore Road
Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997
http,/ANww. muni.org/ons€te
On -Site Wastewater Disposal System Permit
Permit Number: OSP211014
Work Type: SepticTank Upgrade
Tax Code Number: 05047432000
Site Legal Address: HYLEN CREST #3 BLK 6 LT 6 G:0057
Site Mailing Address: 10323 STEWART DR, Eagle River
Owner: STREETS DAVID W & EMILY S
Design Engineer: EKLUTNA ENGINEERING, LLC'
This permit is for the construction of:
Effective Date
Expiration Date:
Lot Size in Sq Ft:
Total Bedrooms:
2/5/2021
2/5/2022
20764
❑ Disposal Field 0 Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage
All construction shall be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80)
3. The wastewater code requires inspections during the installation. The engineer shall notify the Development
Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (2417).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
shall be either:
a. Opened and Closed on the same day, or
b. Covered, sealed, and heated to prevent freezing
1�
Received By:
Issued By: RAW
Date:
S�
Date:
4
MUNICIPALITY OF ANCHORAGE
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
ON-SITE SEPTIC/WELL PERMIT APPLICATION
Parcel I.D. 050-474-32
Property owner(s) STREETS DAVID & EMILY Day phone
Mailing address 10323 Stewart Drive Eagle River AK 99577
Site address 10323 Stewart Drive Eagle River AK 99577
Legal description (Sub'd., Block & Lot) HYLEN CREST #3 BILK
Legal description (Township, Range & Section)
Lot Size 20,764 Sq. Ft. Number of Bedrooms 4
6 LT 6
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DWELLING:
(® all that apply)
Absorption Field
❑
Initial ❑
Single Family (SF) 0
(w/wo ADU)
Septic Tank
0
Upgrade Fxl
Duplex (D) ElHolding
Tank
ElRenewal
F-1Multiple
Dwellings ❑
Privy
❑
(SF and/or D)
Private Well
❑
Water Storage
❑
THIS APPLICATION INCLUDES A WAIVER REQUEST FOR:
Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable MunicipaI Codes.
y
(Signature of
owner or authorized ageht)
Permit/Rush Fees: ZZ Waiver Fees:
Date of Payment: Date of Payment:
Receipt Number: 0 Receipt Number:
Permit No. 05P21 101 y Waiver No.
GADevelopment Services\Building Safety\On Site Water and Was tewater\Forms\Client FormsTermit Application.doc
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP211014, Rebecca Carroll, 02/05/21
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP211014, Rebecca Carroll, 02/05/21
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP211014, Rebecca Carroll, 02/05/21
Municipality of Anchorage Page / of
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: ,~'/4,/ ¢/~/~¢2 PID Number:. ~.~¢r /_./7,Zr, ¢ ,~.
Name: bA/¢/¢~ I~, ,~g~/D Wastewater System: ~New ~ Upgrade
Address: ~ ~ ~
~ ~/~P. ~/< ~5~ ABSORPTION FIELD
No. of Bedrooms:
Phone: ~ ~,~/~ ~ ~ Deep Trench ~ShallowTrench DBed ~Mound ~Other
LEGAL DESCRIPTION so,,.,.~: ~ot.~ ~¢,~ro~
Lob Block: Subdivision: Depth to pipe boltom from original grade: Gravel depth beneath pipe
~ ~ HYLgW ~~ ~ Ft. g.S~ Ft,
Range: ~ Fill added ~bove original grade: Gravel length:
~'~own~, :~/ /~~ S.~,on: F , ~--/ ~t. F/ ~.
WELL: D New D U~~~ Grave~r~: ~ Et. Number~of llne~: ~rsta,ce/~tween Un,,:Ft.
Driller: Date Drilled: Slallo Water Level: Installer: o I ;¢'¢ Date installed: ~
~ GPM PumpSetst: Ft. OasingHeightAboveGrou;;: TANK
SEPARATION DISTANCES ~Septio U Holding U S.T.E.P.
To Septic Absorplion Lift Holding ~rlvale Manufacturer: Capacity In gallons:
Material: Number of Compartments:
We,, +~.~- ~.- ~/// ~//~ ~/~ ~.~
Surface
w.t~ W/~ ~/~ ~/~ ~//~ ~//~ LIFT STATION
Lot Size In g~llons: Manufacturer:
Foundation ¢' //, ~,/~ ~//~ ~/~ "Pump on" level ~ o,," level al: High water alarm at:
Cudai~Drain /"//~ /X//'~ ~/~ / .,.~/¢[, ~//~/Pump M~del Electrical Inspections performed by:
Remarks: BENCH MARK
Location and Description:
I Assumed Elevation:
/0/ dF ~/ Vl ~ 3u~F~g~' FO0,~ ~,
ENGINEE~S:S~AL
Inspections performed by: ~ ~ E ~ Dates' ' ¢"~ ............ ":"'
~,:,: .... ., ~
Department of Health and Human Services approval "'". ......... "
.,~ ¢¢0¢¢0¢V Date: I/,x/O ¢1 ' "' '.'" ' ''~ ...... ~' '
Reviewed and approved by: /
72-013 (1/91)MOA 25
Permit No. 5/V ~/~/~0 Page
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P,O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
Le al Oescri )tion: ~/4~ ~1~, ~/~ ~ PID No,: 0~0- ~ -~
LOT 7
SEPTIC
90,00' \
LOT 5
VACANT
LOT
90,00' '~
SCALE:
ROAD DITCH
I .1
ELEVATIONS
(NOT TO SCALE)
PAVED ROADWAY
4' 35 PS[
INSULATION
[] - TEST: HOLE
o - SEWER CLEANOUT
· - HBNI:fUR TUBE
90.5'
8%0'
1#=50,
72-013 A [2/91) MOA 25
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
PERMIT NUMBER:SW910150
DESIGN ENGINEER:EAGLE RIVER ENGINEERING SERVICES
OWNER NAME:REED DANIEL K
OWNER ADDRESS:HC 85 BOX 9360
EAGLE RIVER, ALASKA 99577
PARCEL ID:05047432
LEGAL DESCRIPTION: HYLEN CREST UNIT #3 BLK
6
6 LT
LOT SIZE: 20764 (SQ. FT.)
NUMBER OF BEDROOMS: 4 THIS PERMIT: 4
PAGE 1 OF
DATE ISSUED: 6/12/91 //~>~
EXPIRATIOR DATE: 6/12/92
THIS PERMIT IS FOR THE CONTRUCTION OF:
DISPOSAL FIELD /SEPTIC TANK SYSTEM
ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH:
1. THE ATTACHED APPROVED DESIGN.
2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS
15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL
REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (iSAACS0).
3. THE FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS:
RECEIVED BY:
ISSUED BY: .
Tom Fink,
Mayor
] unicipality Anchorage
Department of Health and Human Services
825 "L" Street
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
June 13, 1991
Lou Butera, P. E.
Eagle River Engineering Services
PO Box 773294
Eagle River, Alaska 99577
Subject: Waiver Request for Lot 6 Block 6 Hylen Crest S/D ~3
Waiver Request ~WR910021, PID ~050-474-32,
Permit #SW910150
Dear Mr. Butera:
Your request for waiver of the required 10 foot separation
between a septic system and a lot iine has been approved.
waived distance is 5 feet.
The
This approval applies to the existing septic system lot line
separation only. Any future upgrade to the septic system will
require all separations be met or another approval from this
department.
Sincerely,
Daniel J. Roth
Civil Engineer
On-site Services
Concur: j//?
Program Manager
On-site Services
DR/ljm%7
Louis Butera, P.E.
Registered Civil Engineer
May 30, 1991
John Smith, P.E.
Municipality of Anchorage
On-Site Services
825 L Street
Anchorage, AK 99502
Re: Hylen Crest, Lot 6 Block 6
Dear Mr. Smith,
On behalf of our client, Mr. Dan Reed, we are requesting a waiver of separation distance to a
lot line to 5' distance to allow leachfield construction. This variance would allow room for both
a replacement and original system on the South section of the lot. This can only be
accomplished by preplanning the locations and this is the reason for our request. A letter of
non-objection was obtained from effected lot owner.
We are also requesting the leachfield be allowed within the 10' driveway setback with provision
for insulation and earth cover to an equivalent of 6'. Please reference the attached site plan.
If you have any questions please call our office at 694-5195.
Sincerely,
Louis Butera, P.E.
Attachments: site plan
letter of non-objection
P.O. Box 773294 · Eagle River, Alaska 99577 · Telephone {907} 694-5195 · Fax (907) 694-3297
LOT 7 L[]T~ LOT 5 LDT 4
DECK
~BUSE,
~/DECK~ ,~ANK
PAVES ROADWAY
~ - REPLACEMENT AREA
~ - TEST HOLE
NO KNOWN CURTAIN DRAINS o - SEWER CLEANOUT
NO $TREAM3 ~ - MDNI~DR TUSE
LEGAL: LOT 6, BLOCK 6, HYLEN CREST ESTATES
CONTRACTOR:
A EAGLE RIVER ENGfNEERING SERWCES
EAGLE RIVER, AK. 99577
(907) 694-5195 FAX: (907) 694-3297
LDT 7 LBT~, LOT 5 LDT 4
--I
PIPES
VACANT
~ ~BUSE,
LOT
DECK
L L C~F.~_SEPTiC{
P]PES
'~x~KEY BDX
iESMT' "~'~.
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L, Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
SOILS LOG
PERCOLATION
TEST
PERFORMED FOR:
DATE PERFORMED:
LEGAL DESCRIPTION:
I
2
3
4
5
6
7
8
9
lO
11
12
13
14
15
10
17
18
19
20
COMMENTS
SLOPE
SITE PLAN
z
WAS GROUND WATER S
ENCOUNTERED? ./.V~_c£ L
O
~-/U - ~/~ '/~, PE
IF YES, AT WHAT
DEPTH? /I.,Y- ~
Gross Net Depth to Net
Reading Date Time Time Water Drop
PERCOLATION RATE /~ (minutes/inch)
TEST RUN BETWEEN FT AND __ FT
PERFORMED BY:
72-008 (6/79)
Eagle River Engineering Services
P, 0 Rnw
Eagle River, AK 9957?
694~5195
CERTIFIED BY:
SOILS LOG
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L, Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
PERCOLATION
TEST
PERFORMED FOR: X~;; ~""~ /'~ ~:::~' '~"
DATE PERFORMED: ,~T/'~/c)t'
LEGAL DESCRIPTION: ~2 7z'- ~' ,~/Jr' ~
'[14 ~-
1
2
3
4
5
6
7
8
9
10
11
12
13
14-
15
16
17
18
19
2O
SLOPE SITE PLAN
7/-t
~o-
,I
GROUND WATER S
ENCOUNTERED? (V~r [~
P
YES, AT WHAT ~'-/~, - ¢'~/I//'71 E
DEPTH? /"~ ' ~ /
Gross Net Depth to Net
Reading Date Time Time Water Drop
PERCOLATION RATE ~', F minutes/inch)
TEST RUN BETWEEN ~ FT AND ~- FT
COMMENTS
PERFORMED BY:
72-008 (6/79)
Eagle RIvor Engino~ring Services
P. O. Box 773294
Eagle River, AK 99577
6~P-5195
CERTIFIED BY:
SOILS LOG
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
925 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG- PERCOLATION TEST
PERCOLATION
TEST
PERFORMED FOR: ~., )~. r~ ~ ..~
LEGAL DESCRIPTION: '~-.~"~' (--¢~
1
2
3
4
SLOPE SITE PLAN
I0
11
12
13
14
15
16
17-
18
19
2o
WAS GROUND WATER S
ENCOUNTERED? ~ ~
P
E
IF YES, AT WHAT ~.~)
DEPTH? ~
Gross Net Depth to Net
Reading Date l'ime Time Water Drop
PERCOLATION RATE ~-~, \ ~' minutes/inch)
TEST RUN BETWEEN ~' FT AND (~' FT
COMMENTS
PERFOHMED BY:
72-008 (6/79)
10308 LeDoux Lane
Eagle River, Alaska 99577
May 23, 1991
Mr. Lou Butera, PE
Eagle River Engineering Services
P.O. Box 773294
Eagle River, Alaska 99577
Re: Septic System - Lot 6, Block 6, Hylen Crest Third Addition
Dear Mr. Butera,
I am the owner of Lot 5, Block 6, located to the east of Lot 6. I have no
objection to the septic system on Lot 6 being located 5 feet west of our
common property line. At this time, we plan to construct our leachfield
toward the east side of our lot; and in the foreseeable future, only our
driveway will be constructed on our lot in the proximity of the Lot 6
leachfield.
If you have any questions or concerns, please do not hesitate to call.
Sincerely,
ng?/~ A. Roelfs
EAGLE RIVER
ENGINEERING SERVICES
P. O, Box 773294
EAGLE RIVER, ALASKA 99577
Phone 694-5195
SHEET NO.
CALCULATED BY
CHECKED BY
OATE
SCALE
SPECIFICATIONS FOR ON-SITE SEPTIC SYSTEM
LEGAL: LOT 6, BLOCK 6, HYLEN CREST
A. GENERAL
The septic plan is for a single family residence only.
The drawing and or site plan shall be a part of this specification.
All materials and workmanship shall meet the Anchorage Department of Health
and State Department of Environmental Conservation requirements.
All soil tests are advisory to the design and are to be verified or modified in the
field by the engineer.
All excavations and depths are advisory and are to be verified or modified in the
field by the contractor to meet Municipality of Anchorage, Department of
Environmental Conservation requirements.
The excavation is to be exactly in the area shown on the site plan, any deviation
requires engineer approval.
It is always recommended that a surveyor locate the nearest lot line position and
the location of any easements.
DRAINFIELD
2.
3.
4.
5.
6.
7.
8.
The dralnfield is to follow the natural land contour to maintain uniform total depth
of the trench bottom.
The bottom of the drainfield shall be level, plus or minus 1.5".
The total depth of the drainfield excavation is not to exceed 5.5' at any point in
relation to ground surface.
The effluent line from each drainfield is to invert flow from uphill drainfield to
drainfields at lower elevation.
The drainfield gravel is to be covered with typar fabric material.
Soil or combination of soil and extruded board insulation to a depth of 3' or
equivalent is to be placed over the drainfield.
The area over the drainfield is to be finish graded to prevent ponding of surface
water runoff.
The septic tank and leachfield must not be closer than 100' to any existing private
well, 150' to any Class "C" well, or 200 feet to any community well.
RECOMMENDED LEACHFIELD DIMENSIONS:
TOTAL DEPTH = 5.5' GRAVEL DEPTH = 3.5" DRAINFIELD LENGTH = 81'
DRAINFIELD WIDTH = 5' SOIL RATING = 0.8 gpd/FT2
BEDROOM CAPACITY = 4 SEPTIC TANK SIZE = 1,250
WAIVER OF 5' TO LOT LINE m QUIRED
INSULATe Am A OF LEACH TRENCH THAT IS WITmN 10' OF r>IUVEw^Y: .W/ 4,,
BURIAL FOAM. ,: , ~., : .......... ~ .... :"
Louis Butera, P.E.
Registered Civil Engineer
June 28, 1991
Dan Roth
Municipality of Anchorage
825 L Street
Anchorage, AK 99501
Re: Hylen Crest//3, Ix>t 6 Block 6
Dear Mr. Roth,
We are requesting a modification to the previously approved plan for the above referenced
property. The owner is requesting moving his home downhill as far as possible. We have
redrawn the plan to show the reserve area above the home site and have excavated test holes to
verify replacement areas.
If you have any questions please call our office at 694-5195.
Sincerely,
, .,-,~.~,:,.~;;:' .........
Louis Butera, P.E.
P.O. Box 773294 · Eagle River, Alaska 99577 · Teleplme (907) 694-5195 · Fax (907) 69,t-3297
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Certificate of On -Site Systems Approval
Parcel I.D. 050-474-32
Expiration Date: 5/1' 5 ho o) I
1. GENERAL INFORMATION ,
Complete legal description Hylen Crest #3 Block 6 Lot 6
Location (site address) 10323 Stewart Drive G7)�-C`7 LE- 12- t vi --P
Current property owner(s) David Streets Day phone 907.854.7130
Mailing address
Real estate agent
SAME
2. TYPE OF DWELLING:
0 Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 4
Day phone
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Private Well
❑
Private Septic
Z
Water Storage
❑
Holding Tank
❑
Community Well
❑
Community
❑
Public Water System
0
Public Sewer
❑
Waiver request for: Distan
Received by:
COSA to be released to the engineer, unless otherwise requested by the engineer.
Date:
COSA Fee $ Waiver Fee $
Date of Payment % Date of Payment
Receipt Number Receipt Number
COSA # C)JC 19 1 '19 Waiver #
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based
on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the
on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of
bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the
Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater
disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in
effect at the time of installation. I acknowledge that On -Site staff may visit the site to verify the information submitted.
Name of Firm Eklutna Engineering, LLC Phone 907.355.9820
Address 19162 Mountain Rd Chugiak AK 99567
Engineer's Printed Name Curtis Townsend, PE Date June 19, 2020
6. DSD SIGNATURE
.� System #1 Approved for _�_ bedroom
System #2 Approved for
Disapproved
Conditional approval for
bedrooms
bedrooms, with the following stipulations:
By: Uji�(ir!R �ZO Original Certificate Date:
The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the
representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is
not responsible for errors or omissions in the professional engineer's work.
7. ATTACHMENTS:
COSA Checklist X
Septic System Advisory
Well Flow Advisory
COSA Checklist blue sheet
Nitrate Advisory
Arsenic Advisory
Other I a -11-k ak-e. i
COSA Checklist
Legal Description: Hylen Crest #3 Block 6 Lot 6
If more than 1 septic system on lot: COSA Checklist # of
A. WELL DATA
❑ Well log is filed with Onsite (or attached)
Date drilled
Total depth ft
Cased to ft
❑ Sanitary seal is functioning correctly
❑ Wires are properly protected
Casing height (above ) in.
Date of f st for COSA
tatic water level at beginning of test ft.
Comments AWWU, public water
B. TANK DATA
Age of tank(s) 29 years
Tank type/material septic Steel
Measured operating fluid level in septic tank 50
❑■ Standpipes/foundation cleanout per record drawing
Date of pumping 5/29/2020
D. ABSORPTION FIELD DATA
Parcel ID: 050-474-32
Structure served by this system
Well production at time of test
Water storage tank volu gallons
ZWelldisinfetor
caliform test? ❑Yes ElNc
oliform bacteria is Negative
Nitrate mg/L ❑ Nitrate less than MRL (ND)
Arsenic ug/L ❑ Arsenic less than MRL (ND)
Collected by
Date of Sample
C. LIFT STATION
❑ Required maintenance
Age of lift station .
Lift station a mal
Com s:
Which system tested (date installed) 1991
Adequacy test date 6115119
❑■ ALL standpipes present per record drawing
Results [DPass For 4 bedrooms
Total measured depth from grade 6.4 ft (max)
Fluid depth prior to test 13 in
Measured depth to pipe invert from grade 3.6 ft (rein)
Water added 689 gal
❑ NIA —pressurized field
New depth 28 in
❑ Monitor tubes go to bottom of effective. If not, state
Elapsed time 1440 min
depth into effective z.a
107Code-requiredsail cover over field
Final fluid depth 13 in
F-1 System presoaked
Absorption rate '600 gpd
(Required if vacant for greater than 30 days prior to
Any rejuvenation treatment (past 12 months) no
date of test)
Gallons introduced gallons
If yes, enter date
Comments/Deficiencies: 6111/2020 north trench was surcharged. southern trench had 17" ofwater in it
COSA Checklist yellow sheet
E. SEPARATION DISTANCES
From Private Well on Lot to: (Please enter distances if less than required or if community well)
Septic Tank/Lift Station on Lot > 100'
2
Yes
Community Sewer Manhole/Cleanout > 100'
❑ Yes
if No
ft
❑ Yes ' ft
Neighboring Tank > 100' ❑ Yes
if No
ft
Private Sewer/Se ti _ 25' ❑ Yes if No ft
Absorption Field on Lot > 100' ❑ Yes
if No
ft
ng Tank > 100' ❑ Yes if No ft
Neighboring Absorption Fields > 100'
if No
ft
Animal Containment? 50' ❑ Yes if No ft
es
if No
ft
Yes
if No
ft
Community Wells? 200'
Manure/Animal Excreta Storage > 100'
Comm ewer Main > 75' ❑ Yes
if No
ft
❑ Yes if No ft
From Septic/Holding Tank on Lot to: (Please enter distances if less than required)
Building Foundations? 10'
2
Yes
if No
ft
Surface Water? 100'
❑✓ Yes if No ft
Property Line > 5'
0
Yes
if No
ft
Wells on Adjacent Lots:
❑
Absorption Field > 5'
❑✓
Yes
if No
ft
Private Wells > 100'
❑✓ Yes if No ft
Water Main > 10'
71
Yes
if No
ft
Community Wells? 200'
❑✓ Yes if No ft
Water Service Line > 10'
❑�
Yes
if No
ft
If septic tank is under driveway
comment below
From Absorption Field on Lot to: (Please enter distances if less than required)
Building Foundation > 10'
121
Yes
if No
ft
If absorption field is under driveway comment below
Property Line > 10'
❑
Yes
if No 5
ft
Wells on Adjacent Lots:
Water Main > 10'
❑
Yes
if No
ft
Private Wells > 100' 0 Yes if No ft
Water Service Line > 10'
❑✓
Yes
if No
ft
Community Wells > 200' ❑✓ Yes if No ft
Surface Water> 100'
❑✓
Yes
if No
ft
F. ENGINEER'S COMMENTS
absorption field is under driveway. per inspection report there is 4" of insulation
over field within 10' of driveway. no reports of field freezing.
property line waiver WR910021
G. ENGINEER'S CERTIFICATION
I certify that l have determined through field inspections and review
of Municipal records that the above systems are in conformance with
MOA COSA guidelines in effect on this date.
COSA Checklist yellow sheet
ENGINEER'S
STAMP
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT 907‐343‐7904
On‐Site Water and Wastewater Section Fax: 343‐7997
www.muni.org/onsite
Mailing Address: P. O. Box 196650 * Anchorage, Alaska 99519‐6650 * www.muni.org
Septic Tank Advisory
Certificate of On‐Site Systems Approval # OSC191197
Subdivision: Hylen Crest #3 Block:6, Lot: 6
The septic tank for this property is 29 years old. The average life for a steel septic
tank is 20 years. Typical replacement costs range from $7,000 to $11,000.
This advisory must be attached to all copies of the subject Certificate of On‐Site
Systems Approval.
This is an example of what the metal of a 30 year old steel tank MAY look like.
MUNICIPALITY OF ANCHORAGE
Development Services Department C" Phone: 907-343-7904
On -Site Water & Wastewater Section - Fax: 907-343-7997
Certificate of On -Site Systems Approval
Parcel I.D. 050-474-32
1. GENERAL INFORMATION
Expiration Date: C2z 4
Complete legal description Hylen Crest #3 Block 6 Lot 6
Location (site address)
10323 Stewart Drive
Current property owner(s)
Mailing address
Real estate agent
David Streets
SAME
Lindsey Bergeron
2. TYPE OF DWELLING:
0 Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 4
Day phone 907.854.7130
Day phone 907.952.7222
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Private Well
❑
Private Septic
0
Water Storage
❑
Holding Tank
❑
Community Well
❑
Community
❑
Public Water System
El
Public Sewer
❑
Waiver request for: Distance:
Received by: Date:
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $ 5J�
Date of Payment
Receipt Number
COSA # d 5 C l 9 /10
Waiver Fee $
Date of Payment
Receipt Number
Waiver #
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based
on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the
on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of
bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the
Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater
disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in
effect at the time of installation. I acknowledge that On -Site staff may visit the site to verify the information submitted.
Name of Firm Eklutna Engineering, LLC Phone 907.355.9820
Address 19162 Mountain Road Chugiak
Engineer's Printed Name Curtis Townsend, PE Date May 28, 2019
�* IN.y
•*
6. DSD SIGNATURE` --
S
[� stem #1 Approved for
Y Pp bedrooms
:
�—
9�.•. Data
System #2 Approved for bedrooms No, cEt»°"•'ate.:
Disapproved \�\tt�`r•4'�
Conditional approval for bedrooms, with the following stipulations:
By: Original Certificate Date: >� 2 /
The Municipality of Ancho age Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the
representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is
not responsible for errors or omissions in the professional engineer's work.
7. ATTACHMENTS:
COSA Checklist X Nitrate Advisory
Septic System Advisory NlR Arsenic Advisory
Well Flow Advisory Other ! an le,
COSA Checklist blue sheet
COSA Checklist
Legal Description: Hylen Crest #3 Block 6 Lot 6
If more than 1 septic system on lot: COSA Checklist # of
A. WELL DATA
❑ Well log is filed with Onsite (or attached)
Date drilled
Total depth ft
Cased to ft
❑ Sanitary seal is functioning correctly
❑ Wires are properly protected
Casing height (above ground) in.
Date of flow test for COSA
Static water level at beginning of test ft.
Comments AWWU, public water
B. TANK DATA
Age of tank(s) 28 years
Tank type/material steel /See"c-
Measured operating fluid level in septic tank 50
❑■ Standpipes/foundation cleanout per record drawing
Date of pumping 5/15/19
D. ABSORPTION FIELD DATA
Parcel ID: 050-474-32
Structure served by this system
Well production at time of test gpm
Water storage tank volume gallons
Well disinfected for coliform test? ❑ Yes ❑ No
❑ Coliform bacteria is Negative
Nitrate mg/L ❑ Nitrate less than MRL (ND)
Arsenic ug/L ❑ Arsenic less than MRL (ND)
Collected by
Date of Sample
C. LIFT STATION
❑ Required maintenance completed
Age of lift station years
Lift station material
Comments:
Which system tested (date installed) 1991
Adequacy test date 5/15/19
X ALL standpipes present per record drawing
Results QPass For 4 bedrooms
Total measured depth from grade 6.4 ft (max)
Fluid depth prior to test 13 in
Measured depth to pipe invert from grade 3.6 ft (min)
Water added 689 gal
❑ N/A — pressurized field
28
New depth in
❑ Monitor tubes go to bottom of effective. If not, state
1440
Elapsed time min
depth into effective z.s
❑■ Code -required soil cover over field
Final fluid depth 13 in
❑ System presoaked
Absorption rate >600 gpd
(Required if vacant for greater than 30 days prior to
Any rejuvenation treatment (past 12 months) no
date of test)
Gallons introduced gallons
If yes, enter date
Comments/Deficiencies: north trench was surcharged. southern trench only was tested
COSA Checklist yellow sheet
E. SEPARATION DISTANCES
From Private Well on Lot to: (Please enter distances if less than required or if community
Septic Tank/Lift Station on Lot > 100'
0
Yes
CommunitysSewe- Manhole/Cleanout > 100'
ft
❑ Yes
if No
ft
❑ Yes
if No ft
Neighboring Tank > 100'
❑ Yes
if No
ft -',
Private Sewer/Septic Line > 25' ❑ Yes
if No ft
Absorption Field on Lot > 100'
❑ Yes
,... if`N'o
ft
Holding Tank a 100' ❑ Yes
if No ft
Neighboring Absorption Fields
5; 100'
Surface Water> 100'
0
Animal Containment > 50' ❑ Yes
if No ft
ft
❑ Yes
if No
ft
Manure/Animal Excreta Storage > 100'
Community Sewer Main > 75'
❑ Yes
if No
ft
❑ Yes
if No ft
From Septic/Holding Tank on Lot to:
(Please enter
distances if less than required)
Building Foundations > 10'
✓❑ Yes
if No
ft
Surface Water> 100' Yes
if No ft
Property Line > 5'
❑✓ Yes
if No
ft
Wells on Adjacent Lots:
Absorption Field > 5'
M Yes
if No
ft
Private Wells > 100' F, -/l Yes
if No ft
Water Main > 10'
F/I Yes
if No
ft
Community Wells > 200' Q Yes
if No ft
Water Service Line > 10'
❑✓ Yes
if No
ft
If septic tank is under driveway comment
below
From Absorption Field on Lot to: (Please enter distances if less than required)
Building Foundation > 10'
0
Yes
if No
ft
If absorption field is under driveway comment below
Property Line > 10'
❑
Yes
if No 5
ft
Wells on Adjacent Lots:
Water Main > 10'
Yes
if No
ft
Private Wells > 100' Q Yes if No ft
Water Service Line > 10'
0
Yes
if No
ft
Community Wells > 200' Yes if No ft
Surface Water> 100'
0
Yes
if No
ft
F. ENGINEER'S COMMENTS
absorption field is under driveway. Der insDection reaort there is 4" of insulation
over field within 10' of driveway. no reports of field freezing.
G. ENGINEER'S CERTIFICATION
l certify that / have determined through field inspections and review
of Municipal records that the above systems are in conformance with
MOA COSA guidelines in effect on this date.
COSA Checklist yellow sheet
of At.gs
............
L Townseid
Date
FG No. CEi1904 .' �` AN
DEVELOPMENT SERVICES DEPARTMENT ;
On -Site Water and Wastewater Section
www.muni.org/onsite
Septic Tank Advisory
Certificate of On -Site Systems Approval # OSC191197
Subdivision: Hylen Crest #3 Block:6, Lot: 6
907-343-7904
Fax: 343-7997
The septic tank for this property is 28 years old. The average life for a steel septic
tank is 20 years. Typical replacement costs range from $6,000 to $9,000.
This advisory must be attached to all copies of the subject Certificate of On -Site
Systems Approval.
This is an example of what the metal of a 30 year old steel tank MAY look like.
HOUSE
TAMI
PAVED
DRIVE c30'(5'
TH2.
0-� 51*x5l T+1
rIELD V/ 4'
35 PSI 1;Sit- 2. $130.
90.00,
PAVED ROADWAY
CERTIFICATE
FOR A
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water & Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650 ~
Www.r~iuRI.org/oR~k6
(907) 343-7904 ;' .¢,~.
OF ON-SITE SYSTEHS APPROVAL
SINGLE FAH LY DWELLING
Parcel I.D. 050-474-32
1. GENERAL INFORMATION
COSA# f-¢)_~ ~- ..////
Expiration Date: ~2,- ~ g '" / ~
Complete legal description
Location (site address)
Current Property owner(s)
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing address
2. NUMBER OFBEDROOMS:
HYLEN CREST #3; BLOCK 6~ LOT 6
10325-STEWART DRIVE *EAGLE RIVER~ AK 99577
DAN &: JODY REED Day phone
1032,3 STEWART DRIVE *EAGLE RIVER, AK 99577
301-3918
Day phone
SHAWN BABBITT W/ COLDWELL BANKERS Day phone
2525 "C" STREET *ANCHORAGE, AK 99503
562-7653
Unless otherwise requested, COSA will be held by DSD for pickup.
4
3. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well [] Individual On-site ·
Individual Water Storage [] Individual Holding tank []
Community Class Well [] Community On-site []
Public Water System · Public Sewer []
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On-Site Systems
Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of On-Site Systems Approval are required for the transfer
of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or
water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On-Site Systems
Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may
be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water
samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system.
The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
o
STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the vafidation date shown below, I verify that my
investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application,
shov~ that the on-site water supply and/or wastewater disposal s~tem is (are) safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the
information obtained ~rom the Municipality of Anchorage Nas and ~'om my investigation and inspection, t,~a
on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal
and State codes, ordinances, and regulations in effect at the time of installation.
Name of Firm GARNESS ENGINEERING GROUP, Ltd.
Address 5701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507
Engineer's Printed Name JEFFREY A. GARNESS, P.E.
Phone 557-6179
Date
Engineer's Comments:
In conducting this evaluation, GEG, LtD. attempted to provide a thorough,
conscientious engineering analysis of the system in accordance with ADEC and MOA
DSD Guidelines & Regulations. The reported results described the performance of the
system under the conditions encountered at the time of the test, and separation
distances measured to readily identifiable features. The operational life of all wells and
septic systems depend on the local softs condition, groundwater levels that may
fluctuate during the year, and the water usage of the family being served by the system.
These conditions are outside the control of the evaluator of the system. Satisfactory test
results do not guarantee future performance of the system, nor do they guarantee that
there are no hidden defects or encroachments. GEG, LTD. can therefore not provide
any warranty or future estimate of how long the system will continue to meet the
operational requirements of the ADEC or MOA DSD. The content of this report is for
the sole benefit of the owner listed above. Any reliance upon or use of this report by any
other person or party is not authorized, nor will it confer any legal right whatsoever.
DSD SIGNATURE
~Approved for
Disapproved.
bedroOms.
Conditional approval for
~-,: ON-SITE
:. : .:
'~ '. PROGRAM .:
bedrooms, with the following stipulations:-~ <2. %° oo* ./....~
''¢~1"~E1¥1 b~,~''-,' ',
.~tachments: COSA Checklist
Septic System Advisory
Well Flow Advisory
Nitrate Advisory
(Rev. 11/05)
Arsenic Advisory
Maintenance Agreements
Supplementa Engineer's Report
Original Certificate Date:
Municipality of Anchorage
• Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Legal Description:
A. WELL DATA
Well type PUBLIC
Date completed
Total depth ft.
Date of test _
Static water level _
Well production _
WATER SAMPLE RESU
HYLEN CREST #3; BLOCK 6, LOT 6 Parcel ID: 050-474-32
PUBLIC WATER
If A, B, or C provide PWSID#
Sanitary seal (Y/N)
Cased to ft.
FROM WELL LOG
"#
9—
p.m-
Well Log (Y/N)
Wires properly protected (Y/N'
Casing height (abo round)
ft.
ral
Coliform colonies/100 ml. Nitrate mg./L.
Other bacteria colonies/100 ml.
A Ic: ug./L. Date of sample:
Collected by:
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material SEPTIC/STEEL
Date installed 9/3-4/91
Tank size 1250 gal. Number of Compartments 2
Cleanouts (Y/N) YES
Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO
High water alarm (Y/N) N/A
Date of pumping Pumper
C. ABSORPTION FIELD DATA *BELOW EXISTING GRADE
DUAL
Date installed 9/3-4/91 Soil rating (g.p.d./ftzor ftz/bdr 0.8
System type SHALLOW TRENCH
Length 30+51 =81 ft. Width 5 ft.
Gravel below pipe 3.5 ft.
Total depth 6.33 ft. Eff. absorption area 750 ft2 Monitoring tube YES Depression over field NO
Date of adequacy test **2/10/11 Results (Pass/Fail) PASS For 4 bedrooms
Fluid depth in absorption field before test ***23.25 in. Water added 600 gal. New depth ***29.5 in.
Elapsed Time: 120 min. Final fluid depth ***27.5 in.
Absorption rate >= 600+ g,p.d,
Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE
KNOWN If yes, give date —
**SOUTHERN TRENCH ONLY TESTED. NORTH TRENCH WAS SURCHARGED.
***MT DOES NOT EXTEND TO BOTTOM OF TRENCH. LIQUID DEPTH'S WERE CALCULATED BASED
UPON DEPTH TO LIQUID BELOW INVERT.
D. LIFT STATION
Date installed
Size in gallons
Manhole/Access
"Pump on" level at in. "Pump off' level High water alarm level at in.
Datum Cycles tested Meets alarm & circuit requirements?
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot
Absorption field on lot
Public sewer main —
PUBLIC WATER
On adjacent lots
On adjacent lots
manhole/cleanout
Sewer /septi�service line Holding tank
Anima areas Manure/animal excrete storage areas
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+ Absorption field
Water main 10'+ Water service line 10'+ Surface water
Wells on adjacent lots 200'+
5'+
100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line *5'+ Building foundation 10'+ Water main 10'+
Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 01
Curtain drain NONE KNOWN Wells on adjacent lots 200'+
F. COMMENTS
*WR#910021. DRAINFIELD WAS ESSENTIALLY 85% FULL PRIOR TO START OF ADEQUACY TEST.
G.
ENGINEER'S CERTIFICATION o �F..'q'��v���
I certify that I have determined through field inspections and
review of Municipal records that the above systems are in
conformance with MOA COSA guidelines in effect on this ` r`
date.
QO � •Jeffs A. Gar ess;'
Engineer's Printe Name JEFFREY A. GARNESS O 9• a•. FE -79 3
Date 3 1 i I r pOea P o� �o
rofessi��o�
COSA Fee $ Waiver Fee $
Date of Payment Date of Payment
Receipt Number Receipt Number
(Rev. 11/05)
0
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastewater Program
4700 Elmore Street
P.O. Box 196650 Anchorage, AK 99519-6650
www. ci. anchorage, ak.us
(907) 343-7904
Septic System Advisory
Certificate of On-Site Systems Approval # 111056
During a recent adequacy test on the septic system for Block 6, Lot 6 of
Hylen Crest #3 subdivision, 32 inches of standing water was observed in the
absorption fieldl This indicates that approximately 88% of the absorption
area is inundated. Although this system passed the adequacy test, the
remaining life expectancy may be limited.
This advisory must be attached to all copies of the subject Certificate of On-
Site Systems Approval
From:UPS STORE EAGLE RIVER ALASKA To:3383246 02/22/2011 19:18 g278 P. 002/002
ASBUILT-NO CORNERS SET THIS D~TI~':- SEWARD & A~SOCTAT]:L~ LA.~TD
YED THE I SCALE'
6, 1" = 30' p~. OF/1~'.~ .
3 .D~ATe, ~2", ........ ~ ~ ~
ANT ~R~D: ,.-..~...~ ...... ,
~ND- DRAWN, A.'~ L~
I HEREBY CERTIFY THAT I HAVE SURVEY
FOLLOWING DESCRIBED PROPERTY:
Block 6, Hylen Crest Subd., Unit No.
AND THAT NO ENCROACHMENTS EXIST
INDICATED. IT IS THE RESPONSIBILITY
OWNI3~ TO DETERMINE THE EXISTENCE OF
EASEMENTS, COVENANTS, OR .RESTRICTI
WHICH DO NOT JU=PEAR ON THE RECORDED
V/SION PLAT. UNDER NO CIRCUMSTANCES
~ DATA HEREON BE USED FOR CONST~
OF FENCE LINES, OR FOR ESTABLISHING
ARY LINES.
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
Division of Environmental Services
On-Site Services Section
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
Parcel I.D. #
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
1. GENERAL INFORMATION
Complete legal descriptionLot 6, Blk 6, Hylen Crest Unit #3
Location (site address or directions) Stewar~: Dr. ~.acj].e R±ver
Property owner Dan±eZ ~: Reed Dayphone 694-53Z8
Mailing address HC 85 Box 9360, ]gaqle R±ver, A~( 99.577
Lending agency N/A Day phone
Mailing address
Agent N/A
Ad dress
Unless otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS: '~
TYPE OF WATER SUPPLY:
Individual well
Community well ×
NOTE:
Day phone
Public water
If community well system, provide written confirmation from State ADEC attest-
log to the legality and status of system.
TYPE OF WASTEWATER DISPOSAL:
Individual on-site
Holding tank
Community on-site
NOTE:
Public sewer
If community wastewater system, provide written confirmation from State AD£C
attesting to the legality and status of system.
72-025 (Rev, 1/91) Front MOA #21
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation of this Health Authority Approval application shows that the on-site water supply
and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms
and type of structure indicated herein. I further verify that based on the information obtained from
the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is in compliance with all Municipal and State codes,
ordinances, and regulations in effect on the date of this inspection.
Name of Firm
Address
Engineer's signature
Eagle River En[inearing Scrvic0s
P. O. Box 775z94
Eagle River, Al( 99577
094-5195
6. DHHS SIGNATURE
~, Approved for ~¢- bedrooms.
Phone
Disapproved.
Conditional approval for
bedrooms, with the following stipulations:
Additional Comments
By: .--.~ O H-M -,~'t", r'F~! Date
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority
Approval Certificates based only upon the representations given in paragraph 5 above by an independent
professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes
and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not
conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not
responsible for errors or omissions in the professional engineer's work.
72~25 (Rev. 1/91) Back MOA/J21
Municipality of Anchorage
Department of Health & Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: ,/-~¢-¢-/ ,¢*//-r ¢ /¢'_¥/¢*' 4~'~ ~',g Parcel I.D.
A. WELL DATA
//.~
Well type ~
Log present (Y/N)
Total depth
Sanitary seal (Y/N)
~7~%r ,,¢ ~
If A, B, or C, attach ADEC letter.
Date completed
Cased to
FROM WELL LOG
Date of test
Static water level
Well flow
Pump level
SEPARATION DISTANCES FROM WELL TO:
Septic/holding tank on lot
Absorption field on lot
Public sewer main
Public sewer service line
ADEC water system number
Driller
Casing height
Wires properly protected (Y/N)
AT INSPECTION
g.p.m.
; On adjacent lots
; On adjacent lots_
Public sewer manhole/cleanout
Petroleum tank
WATER SAMPLE RESULTS:
Coliform
Date of sample:
Nitrate Other bacteria
Collected by:
B. SEPTIC/HOLDING TANK DATA
Date installed
Cleanouts (Y/N)
High water alarm (Y/N)
Date of pumping
Tank size /'"~'-¢'¢ Compartments
Foundation cleanout (Y/N) ¢Y' Depression (Y/N)
Alarm tested (Y/N)
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
Well(s) on lot P)/4- On adjacent lots 'a/'/'c~r Foundation ;2 /
To property line /~ Absorption field ,5 Water main/service line
Surface water/drainage ,~ / ,4 '
72-026 (Rev. 3/91) Front MOA 21 CONTINUED ON BACK PAGE
C. LIFT STATION
Date installed
Size in gallons
Vent (Y/N)
High water alarm level
Meets MOA electrical codes (Y/N)
"Pump on" level at
Manufacturer
Manhole/Access (Y/N)
"Pump off" level at
Cycles tested
SEPARATION DISTANCE FROM LIFT STATION TO:
Well on lot On adjacent lots
Surface water
D. ABSORPTION FIELD DATA
Date installed /~ ~' /
Length ~P'/ Width _ ..~-
Total absorption area
Depression over field (Y/N)
Results (pass/fail)
(past 12 months) (Y/,~
Peroxide
treatment
Soil rating
Gravel thickness 3=, a'-
Cleanouts present (Y/N)
Date of adequacy test
for ~
If yes, give date
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Well on lot /.v ~.,...¢~
To building foundation
On adjacent lots ¢' '2'ox
Surface water ,~' 7/4
Curtain drain /v?4
System type 2'~¥'~'"' ~'~ ~'~
Totaldepth 5'7, J-
bedrooms
On adjacent lots ~"~¢¢' Property line ¢"
To existing or abandoned system on lot /d
Cutbank ,,,//,4 Water main/service line '~
Driveway, parking/vehicle storage area
E. ENGINEER'S CERTIFICATION
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
Signature
Engineer's Name
Date
HAA Fee $
Date of Payment
Receipt Number
72-026 (Rev. 3/91) Back MOA
Waiver Fee: $
Date of Payment
Receipt Number
DEPT. OF ENVIi~ONMENTALCONSERVATION
ANCHORAGE DISTRICT OFFICE
3601 "C" STREET, SUITE 322
ANCHORAGE, ALASKA 99503
563-6775
November 19, 1991
FOR: Eagle River Engineering
PWSID # 213289
My review of the records on file In this office reveals that the Hylen Crest Subdivision
Class '%" Public Water System, Is in compliance with the routine coliform bacteria samples
requirements listed in Table C, and with the inorganic sampling listed In Table B of 18 AAC
80.200.
BR/cf
Sincerely,
Byron Roys
Environmental Engineer
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